Commercial Credit Application

We appreciate the opportunity to work with you and your company.

Upon submission, this application will be sent directly to our Credit Department for review.

Raben Tire Co., LLC

Date*
MM slash DD slash YYYY

Company Name*

Federal Tax ID#*

Address*
Street Address Address Line 2 City State ZIP Code

Phone*
Fax
Email*

Purchase Order Required?*
Yes
No
Tax Exempt?*
Yes
No
UPLOAD TAX EXEMPT FORM

Drop files here or

Accepted file types: pdf, jpg, png, gif, Max. file size: 2 MB.

Type Of Business*
Corporation
S-Corporation
Proprietorship
Partnership

If Proprietorship, Partnership, or S-Corporation, section below MUST be completed.
The undersigned individual who is either a principle of the credit applicant or a sole proprietorship of the credit applicant, recognizing that his or her individual credit history may be a factor in the evaluation of the credit history of the applicant, hereby consents to and authorizes the use of a consumer credit report on the undersigned by Raben Tire Co., LLC from time to time as may be needed, in the credit evaluation process.
Name*

Date
MM slash DD slash YYYY

Signature*
Subsidiary Or Division?*
Yes
No
Please Provide Name of Parent Company*

Do You Have A Trade/Bank References File To Upload*

Yes

No
UPLOAD REFERENCES FILE*

Drop files here or

Accepted file types: pdf, jpg, png, gif, Max. file size: 2 MB.

IF NO FILE TO SEND, PLEASE GO UP AND MARK NO FOR DO YOU HAVE A TRADE/BANK REFERENCES FILE TO UPLOAD

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Trade Reference #1 - Name

Trade Reference #1 Information
Street Address Address Line 2 City State ZIP Code

Email

Phone
Fax

Trade Reference #2 - Name

Trade Reference #2 Information
Street Address Address Line 2 City State ZIP Code

Email

Phone
Fax

Trade Reference #3 - Name

Trade Reference #3 - Information
Street Address Address Line 2 City State ZIP Code

Email

Phone
Fax

Name of Bank

Type of Account
Checking
Loan
Bank Address
Street Address Address Line 2 City State ZIP Code

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Applicant's signature attests financial responsibility, ability and willingness to pay in accordance with the terms as may appear on each invoice, and further agrees to pay a late charge of 1.5% per month (18% per annum) on all past due balances. The above information is for the purpose of obtaining credit and is warranted to be true. I/We hereby authorize Raben Tire Co., LLC to investigate the references listed pertaining to my/our credit and financial responsibility.
Name*

Title*

Date*
MM slash DD slash YYYY

Signature*
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PERSONAL GUARANTY
In consideration of your extending credit at my request to:
Name of Company

Hereinafter referred to as "company", of which I am:
Guarantor Title

I hereby, absolutely and unconditionally, personally guarantee the full and punctual payment of any obligation of the company and I hereby bind myself to pay you on demand any sum, including all costs of collection and reasonable attorney's fees, which may become due you by the company whenever the company shall fail to pay the same. It is understood that this guaranty shall be a continuing and irrevocable guaranty and indemnity for such indebtedness of the company. I do hereby waive notice of demand, protest or default and consent to any modification or renewal of the credit agreement hereby guaranteed. The undersigned personal guarantor, recognizing that his or her individual credit history may be a necessary factor in the evaluation of this personal guaranty, hereby consents to and authorizes the use of a consumer credit report on the undersigned, by the above named business credit grantor, from time and time as may be needed, in the credit evaluation process.
Date
MM slash DD slash YYYY

Guarantor of Company

Signature
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For Security Reasons, the Raben Tire Credit Department may reach out to you by phone for additional information.